Individual
DR. BRADLEY JACK POLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
203 S 6TH ST, WOOD RIVER, IL 62095-2345
(618) 254-9355
(618) 254-9351
Mailing address
203 S 6TH ST, WOOD RIVER, IL 62095-2345
(618) 254-9355
(618) 254-9351
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.013756
IL
111N00000X
Chiropractor
2021016090
MO
Other
Enumeration date
05/06/2021
Last updated
10/19/2021
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